_Compression._--Digital compression of the feeding artery has been given
up except as a preparation for operations on the sac with a view to
favouring the development of a collateral circulation.
_Macewen's acupuncture or "needling"_ consists in passing one or more
fine, highly tempered steel needles through the tissues overlying the
aneurysm, and through its outer wall. The needles are made to touch the
opposite wall of the sac, and the pulsation of the aneurysm imparts a
movement to them which causes them to scarify the inner surface of the
sac. White thrombus forms on the rough surface produced, and leads to
further coagulation. The needles may be left in position for some hours,
being shifted from time to time, the projecting ends being surrounded
with sterile gauze.
|